N.M. Stat. § 59A-47-34
Continuation of coverage and conversion rights; health
care plans.
A. Every individual or group contract entered into by a health care plan that provides
for health care expense payments on a service benefit basis or an indemnity benefit
basis or both and that is delivered, issued for delivery or renewed in this state on or
after July 1, 1984 shall provide covered family members of subscribers the right to
continue such coverage through a converted or separate contract upon the death of the
subscriber or upon the divorce, annulment or dissolution of marriage or legal separation
of the spouse from the subscriber. Where a continuation of coverage or conversion is
made in the name of the spouse of the subscriber, such coverage may, at the option of
the spouse, include coverage to dependent children for whom the spouse has
responsibility for care and support.
B. The right to a continuation of coverage or conversion pursuant to this section
shall not exist with respect to any covered family member of a subscriber in the event
the coverage terminates for nonpayment of premium, nonrenewal of the contract or the
expiration of the term for which the contract is issued. With respect to any covered
family member who is eligible for medicare or any other similar federal or state health
insurance program, the right to a continuation of coverage or conversion shall be limited
to coverage under a medicare supplement insurance contract as defined by the rules
and regulations adopted by the superintendent of insurance.
C. Coverage continued through the issuance of a converted or separate contract
shall be provided at a reasonable, nondiscriminatory rate to the insured and shall
consist of a form of coverage then being offered by the health care plan as a conversion
contract in the jurisdiction where the person exercising the conversion right resides that
most nearly approximates the coverage of the contract from which conversion is
exercised. Continued and converted coverages shall contain renewal provisions that
are not less favorable to the subscriber than those contained in the policy from which
the conversion is made, except that the person who exercises the right of conversion is
entitled only to have included a right to coverage under a medicare supplement
insurance contract, as defined by the rules and regulations adopted by the
superintendent of insurance, after the attainment of the age of eligibility for medicare or
any other similar federal or state health insurance program.
D. At the time of inception of coverage, the health care plan shall provide each
covered family member eighteen years of age or older a statement setting forth in
summary form the continuation of coverage and conversion provisions of the
subscriber's contract.
E. The eligible covered family member exercising the continuation or conversion
right must notify the health care plan and make payment of the applicable premium
within thirty days following the date such coverage otherwise terminates as specified in
the contract from which continuation or conversion is being exercised.
F. Coverage shall be provided through continuation or conversion without additional
evidence of insurability and shall not impose any preexisting condition, limitations or
other contractual time limitations.
G. Any probationary or waiting period set forth in the converted or separate contract
is deemed to commence on the effective date of the applicant's coverage under the
original contract.